503 AN INTERNATIONAL MULTI-CENTRE STUDY EXAMINING DIAGNOSTIC CRITERIA FOR ACTIVE SURVEILLANCE IN MEN UNDERGOING RADICAL PROSTATECTOMY
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Résumé
You have accessJournal of UrologyProstate Cancer: Localized II1 Apr 2012503 AN INTERNATIONAL MULTI-CENTRE STUDY EXAMINING DIAGNOSTIC CRITERIA FOR ACTIVE SURVEILLANCE IN MEN UNDERGOING RADICAL PROSTATECTOMY Lih-Ming Wong, David Neal, Richard Johnston, Nimesh Shah, Anne Warren, Chris Hoven, Larry Goldenberg, Martin Gleave, Anthony Costello, and Niall Corcoran Lih-Ming WongLih-Ming Wong Cambridge, United Kingdom More articles by this author , David NealDavid Neal Cambridge, United Kingdom More articles by this author , Richard JohnstonRichard Johnston Cambridge, United Kingdom More articles by this author , Nimesh ShahNimesh Shah Cambridge, United Kingdom More articles by this author , Anne WarrenAnne Warren Cambridge, United Kingdom More articles by this author , Chris HovenChris Hoven Melbourne, Australia More articles by this author , Larry GoldenbergLarry Goldenberg Vancouver, Canada More articles by this author , Martin GleaveMartin Gleave Vancouver, Canada More articles by this author , Anthony CostelloAnthony Costello Melbourne, Australia More articles by this author , and Niall CorcoranNiall Corcoran Melbourne, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.574AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are numerous inclusion criteria for active surveillance (AS) and discrepancies reflect the uncertainty in predicting the true rate of prostate cancer with adverse features. Given that disease characteristics may display regional differences, it is possible that the application of a selection rule generated from one population may result in inaccurate estimation of disease risk when applied to different cohorts. We examined effects of Klotz and Van den Bergh (Prostate Cancer Research International: Active Surveillance, PRIAS) AS selection criteria on the detection of true low risk prostate cancer. METHODS From three centers in UK, Canada and Australia, prospective data on men who underwent radical prostatectomy was collated. Men initially suitable for AS, according to Klotz and PRIAS criteria, had prostatectomy specimens analyzed for pathological upgrading (Gleason score >7) and upstaging (>pT3 disease). Mann-Whitney U or Kruskal-Wallis ANOVA modelling evaluated differences in continuous variables and Pearson's Chi-squared or Fisher's exact test determined differences between categorical variables. Multivariable logistic regression was performed to identify predictors of high-risk disease. A nomogram was generated by logistic regression analysis, and performance characterized by ROC curves. RESULTS 800 men met the Klotz criteria, and 410 met the more stringent PRIAS criteria. For Klotz and PRIAS groups, the rates for upgrading were 50.6%, and 42.7%, and upstaging 17.6%, 12.4% respectively. Significant predictors of high-risk disease were: - Klotz group: increasing age (OR1.04, p=0.02), presence of palpable disease (OR1.54, p=0.045), centre of diagnosis (Cambridge OR2.85, p<0.001) and number of positive cores (OR1.25, p<0.001). - PRIAS group: increasing PSA (OR1.15, p=0.043) and presence of palpable disease (OR1.85, p=0.04). Cambridge had a high pT3a rate (26% vs. 12%). To assist selection of men in the UK for AS, from the Cambridge data, we generated a nomogram predicting high-risk features in patients who meet the Klotz criteria (AUC of 0.72). CONCLUSIONS The rate of high-risk disease in prostatectomy patients who pre-operatively meet criteria for AS varies geographically. We found higher rates of re-classification (42.7-50.6%) than previously reported from Europe and North America (23-35%). With more stringent selection criteria, there is less reclassification but also fewer men who may benefit from AS. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e206-e207 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lih-Ming Wong Cambridge, United Kingdom More articles by this author David Neal Cambridge, United Kingdom More articles by this author Richard Johnston Cambridge, United Kingdom More articles by this author Nimesh Shah Cambridge, United Kingdom More articles by this author Anne Warren Cambridge, United Kingdom More articles by this author Chris Hoven Melbourne, Australia More articles by this author Larry Goldenberg Vancouver, Canada More articles by this author Martin Gleave Vancouver, Canada More articles by this author Anthony Costello Melbourne, Australia More articles by this author Niall Corcoran Melbourne, Australia More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».